Brain injury is the leading cause of death after cardiopulmonary resuscitation.Clinical care for brain injury remains necessary.Therapeutic hypothermia has been shown to be effective in improving neurological outcome of children with cardiac arrest.We routinely induced hypothermia in children with coma after cardiac arrest,targeting 32 ～ 34 ℃,using cooling blankets and intravenous ice cap as primary methods for induction,for 24 ～ 72 h or much more duration,and vigilant re-warming.The objective of this article was to share our hypothermia protocol for cooling children with acute brain injury after cardiac arrest.

Pathological myopic macular retinoschisis can be classified into 4 types based on optical coherence tomography (OCT) images: outer layer retinoschisis, outer + middle layer retinoschisis, outer + inner layer retinoschisis and muhilayer retinoschisis. Currently vitrectomy is the major option to treat this condition as it can remove the posterior vitreous cortex completely and peel the internal limiting membrane (ILM) around the posterior vessels arch. Vitrectomy benefits the visual function significantly for outer layer retinoschisis with foveal detachment, but has no or very little effects on muhilayer retinoschisis. The appropriate starting site for removal of posterior cortex and ILM should be the site without inner layer retinoschisis. The knowledge and understanding of the OCT classification of pathological myopic macular retinoschisis is important for us to chose correct operation methods and determine the prognosis after treatment.

Pediatric intensive care unit(PICU) is the last guarantee for children whose lives were threatened.Brain injury are accompanied in many patients,in which ones dying or surviving were associated with whether their cerebral function would be recovered.Closely monitoring the brain function,especially the metabolic balance of cerebral oxygenation to detect cerebral hypoperfusion and low oxygen delivery and timely interventions being introduced can reduce mortality and longterm sequela.Current trends in monitoring cerebral oxygenation are poor in PICUs of our country.It is very helpful in evaluating cerebral function and predicting prognosis from learning characteristics of cerebral oxygenic balance and monitoring methods of cerebral oxygenation.At present,monitoring cerebral oxygen includes intracranial pressure,cerebral perfusion pressure,jugular venous oxygen saturation,brain tissue oxygen tension,cerebral blood flow,and near infrared spectrum technology and so on.

To explore the feasibility of mesenchymal stem cells (MSCs) acting as seed cells in tissue engineering, we isolated human bone marrow MSCs and differentiated them into vascular endothelial-like cells (ELCs) in vitro. Bone marrow mononuclear cells (BMSCs) were isolated by the method of percoll density centrifugation, and seeded in Dulbecco Modified Eagle Medium supplemented with 10% fetal bovine serum. MSCs were purified through multiple adherent cultures, and differentiated into ELCs induced by endothelial cell growth medium-2 (EBM-2) medium containing vascular endothelial growth factor (VEGF), human fibroblast growth factor (hFGF), insulin like growth factors 1 (IGF-1), and human epidermal growth factor (hEGF). The relative biologic characteristics of ELCs including cell morphology and phenotype were studied by inverted microscope and flow cytometry. The induced cells were identified by immunofluorescence with CD31 and Von Willebrand factor (vWF). The results showed that the morphology of MSCs was long-spindle and vortex-like growth. After induction of differentiation, the cells were round, and similar to vascular endothelial cells (ECs). Flow cytometric analysis revealed that ELCs expressed ECs specific surface markers of CD31 and vascular endothelial cadherin (VE-cadherin), but not CD133. Immunofluorescence results also confirmed that ELCs expressed CD31 and vWF. The results suggested that ELCs possed similar cell biological characteristics with ECs. In one word, human MSCs derived from bone marrow have the potential to differentiate into ECs in vitro, and show clinical feasibility acting as ideal donor cells of vascular tissue engineering.
Antigens, CD ; metabolism ; Bone Marrow Cells ; Cadherins ; metabolism ; Cell Culture Techniques ; Cell Differentiation ; Cells, Cultured ; Culture Media ; chemistry ; Endothelial Cells ; cytology ; Epidermal Growth Factor ; pharmacology ; Fibroblast Growth Factors ; pharmacology ; Flow Cytometry ; Humans ; Insulin-Like Growth Factor I ; pharmacology ; Mesenchymal Stromal Cells ; cytology ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Tissue Engineering ; Vascular Endothelial Growth Factor A ; pharmacology ; von Willebrand Factor ; metabolism

[Objective]To evaluate the surgical technique and effectiveness of extra-articular arthroscopic debridement in patients with rotator cuff calcifying tendinitis unresponsive to conservative treatment.[Methods]Arthroscopic debridement was performed in 18 patients(5 males,13 females;mean age 56.4,range 34 to 78) in whom pain and functional disability persisted for more than 3 months despite conservative therapy for rotator cuff calcifying tendinitis.Arthroscopy was inserted into subacromial interspace and bursectomy was done.Calcified plaques in supraspinatus tendon were explored and eliminated outside shoulder joint under arthroscopy.VAS pain score,Constant-Murley score and plain radiograph was adopted for evaluation before and after surgery.[Results]The mean follow-up period was 9 months(6 to 15 months)[KG-58x].Pain and functional disturbance of the shoulder disappeared or obviously improved.The average VAS pain score was(7.8?0.6) preoperatively and(1.7?0.4) postoperatively.The average Constant-Murley score was(61?7)preoperatively and(91?4)at the last follow-up.Radiograph showed little residual deposits in 2 cases but without preoperative symptoms.No case need rotator cuff repair.[Conclusion]Extra-articular arthroscopic removal of calcium deposits together with bursectomy is effective and reliable in patients with chronic calcifying tendinitis unresponsive to conservative treatment.

Objective:To investigate the effects of extraction orthodontic treatment on the upper airway dimensions in young adult patients with malocclusion,and to evaluate the relationship between changes in the craniofacial morphology,position of incisor and upper airway dimensions.Methods:26 patients with upper and lower first premolar extraction and 21 patients without extraction were recruited.Cephalometry and dental cast analysis were performed pretreatment and posttreatment.Results:No statistical difference was found in the parameters of the upper airway dimensions in both non-extraction group and extraction group after treatment.In linear correlation analysis,SPAS was positively correlated with cephalometric variables U1-Y and L1-Y.MAS and IAS was positively correlated with cephalometric variables SNB,U1-Y and L1-Y.The multiple regression analysis revealed that the change of U1-Y had a significant positive effect on SPAS and IAS,and the change of L1-Y also had a significant positive effect on SPAS and MAS.Conclusion:The upper airway dimensions can not be altered during extraction orthodontic treatment,while the changes of incisors are significant associated with the change of the upper airway dimensions.

Objective To study the application and influential factors of urine tissue polypeptide specific antigen(TPS) for early detection and clinical outcome in bladder transitional cell cancers (BTCC). Methods Urine TPS in 76 cases of newly diagnosed BTCC,42 cases of recurrent BTCC,26 cases of postoperative BTCC with normal urine cytology,28 cases of benign bladder diseases,42 normal controls were determined by ELISA.The TPS levels were compared with the cystoscopic results and pathological findings.The relationship between urinary TPS level and the development and prognosis of BTCC was analyzed. Results The urine TPS level was not related to age and sex.The TPS levels in newly diagnosed BTCC group,recurrent BTCC group,postoperative BTCC with normal urine cytology group, bladder benign diseases group and control group were (341?403)U/L,(212?166)U/L,(168?115)U/L,(135?48)U/L and (81?37)U/L,respectively.There was significant difference between each other (all P

Early newborns,especially premature and very low birth weight infants (VLBWI)are vulnerable to low environmental temperature and/or other factors at birth,they may be insufficient to maintain core body and can cause hypothermia which leads to a variety of disease,affecting their life quality.As the birth rate of premature newborns and VLBWI are increasing in China these years,newborns temperature management have become significant for decreasing newborn's mortality.The main causes for hypothermia are low environmental temperature,insufficient calorie intake,premature newborns,low birth weight and other diseases.Studies shown that the prevention strategies of neonatal hypothermia include:(1) thermal neutral zone;(2) incutators and radiant warmers;(3) plastic hoods and plastic blankets;(4) kangaroo care;(5) breast feeding.

Objective To investigate the effect of the use of audio and video feedback on the rehabilitation of patients with ankylosing spondylitis (AS). Methods 60 AS patients were divided into two parts (32 in the experimental group and 28 in the control group) by random number table method, and two groups of patients were treated with the same drug treatment. Patients in the control group were instructed by oral instruction, in the experimental group, the use of audio and video feedback teaching guide patients family exercise, compared with the two groups of patients with four months of follow-up, family exercise compliance, joint function and quality of life, and other indicators. Results Four months after the intervention, the experimental group patients family exercise compliance was better than 84%(27/32), higher than the control group of 36% (10/28), the difference was statistically significant (χ2=9.238, P < 0.01). Patients in the experimental group in four months after the intervention, the health questionnaire to investigate the physiological function, role limitation due to physical problems, body pain, general health, vitality, social function, role limitation due to emotional problems, mental health eight dimension scores respectively were (72.7±8.4), (81.5±9.5), (57.2±8.4), (65.5±8.4), (62.9±7.2), (78.4±7.4), (67.3±6.2), (77.2±7.6) points while in the control group were (60.8±9.1), (72.1±9.6), (50.3±9.4), (60.8±7.0), (58.2±9.1), (74.4±8.7), (60.2±7.2), (74.3±7.4) points, the difference between the two groups had statistical significance (t=1.493-5.266, P < 0.05 or 0.01). Four months after the intervention, the scores of Bath Ankylosing Spondylitis Functional Index (BASFI) of patients with AS in the experimental group were (1.1± 0.8), (1.7±0.2), (1.8±1.3), (1.6±1.0), (3.1±2.1), (1.0±0.6), (1.9±1.6), (3.8±2.5), (2.6±1.7), (2.7±1.6) points, while (3.8±1.6), (2.8±1.5),(2.6±1.5)、(2.8±1.2),(4.4±2.2),(2.2±1.0),(3.3±1.6),(6.5±2.5),(5.6±2.6), (4.3 ± 1.5)control group, the two groups the difference was statistically significant (t=0.282-8.427, P<0.05). Conclusions Application of audio and video feedback teaching in patients with AS rehabilitation guidance, help patients to master the family training methods, improve the joint function of patients, improve the quality of life.

Objective To investigate the effectsof quercetin on human umbilical vein endothelial cell (HUVEC)-12 undergoing endothelial-to-mesenchymal transition (EndMT) induced by TGF-β1; To discuss its mechanism of action. Methods Cell activity of intervening by quercetin with different concentrations and TGF-β1 for 72 h was detected by CCK-8 method;RT-PCR and immunofluorescence staining were used to detect the transition of endothelial and stromal markers; Western blot was used to detect the signal transduction pathway; RT-PCR was performed to detect the transcription factors that play crucial roles in the process of transformation. Results The results of RT-PCR and immunofluorescence double staining showed that TGF-β1 (10 ng/mL) stimulated HUVEC-12 cells for 72 h to induce fibroblast phenotype, showing more interstitial markers and less endothelial markers;Western blot and RT-PCR results showed that quercetin inhibited the phosphorylation of smad2/3 in a concentration-dependent manner;After TGF-β1 stimulation, the downstream transcription factors EndMT of snail1, twist1, twist2, ZEB1, and ZEB2 significantly increased, while 100 μmol/L quercetin could down-regulate the five downstream transcription factors. Conclusion Quercetin has anti-fibrosis effects through inhibiting HUVEC-12 cells undergoing EndMT.